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Pre-Registration
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French 525 Paris: Ville du Monde Preregistration Deposit Form 2006

Please fill out this form carefully and return it by March 1st* to Dr. Vanderboegh with a check in the amount of $200.00 made out to Creighton University. (by U.S. Mail or delivered by hand)
* Enrollment closes at 12 students.

                    Dr. David Vanderboegh
                    Department of Modern Languages
                    Creighton University
                    2500 California Plaza           
                    Omaha, NE 68178       

Name:         _______________________________________

Address:      _______________________________________

_______________________________________

Telephone:   _______________________________________

E-Mail:         _______________________________________

•Room preference:
Select one of the options below. The more to a room, the lower the cost. Every effort will be made to assign you to the room configuration of your choice.

____ Single  (special request only, will add over $400 above the cost of a double room)

____ Double                        Smoking preference:

____Triple                        ____ smoking        ____non-smoking                       
•Roommate request (optional).
  Write the name(s) of student(s) with whom you would like to share a room below.

__________________________________

__________________________________

_____ Check here if you would like to take the optional day-trip to London on the Eurostar.
    (Will cost an additional $120 or so depending on currency exchange and rates).

•Do you have any special needs or concerns? Please list them below, or contact Dr. Vanderboegh.

_________________________________________________________________________

_________________________________________________________________________

•Important reminder: If you do not already have a valid passport, now is the time to apply!
The U.S. Postal Service has special offices for passport applications. Call ahead for information on what you will need to apply.